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Hypopituitarism

What is hypopituitarism?

Hypopituitarism happens when your pituitary gland is not active enough. As a result the gland does not make enough pituitary hormones.

The pituitary is a small gland at the base of your brain. It is one of several glands that make hormones. Hormones are chemicals that send information and instructions from one set of cells to another. The pituitary gland makes many types of hormones. These hormones affect many things, including bone and tissue growth, your thyroid gland, and sexual development and reproduction.

What causes hypopituitarism?

Causes can directly affect the pituitary gland. Or they can indirectly affect the gland through changes in the hypothalamus. This is a part of the brain that is just above the pituitary gland. The hypothalamus makes hormones that help the pituitary gland work normally.

Direct causes include:

Pituitary tumors

Poor blood supply to the pituitary gland

Infections or inflammatory diseases of the brain

Radiation treatment

Surgery to remove pituitary tissue

Autoimmune diseases

Brain injury

Genetic diseases and syndromes

Rare diseases such as sarcoidosis and amyloidosis

Indirect causes include:

Hypothalamus tumors

Inflammatory disease or a disease that spreads to the pituitary, such as cancer

Head injuries

Surgical damage to the hypothalamus or blood vessels or nerves leading to it

Certain medicines such as opioids that decrease hormone secretion from the hypothalamus

What are the symptoms of hypopituitarism?

Symptoms are different for each person. They may happen over time or right away. They depend on which hormones the pituitary gland is not making enough of. These hormone deficiencies, and the symptoms they cause, include:

Not enough gonadotropins (luteinizing hormone and follicle-stimulating hormone). This affects women who have not gone through menopause. They may not have a menstrual period. They may have problems with fertility, vaginal dryness, and loss of some female traits. Men may have problems with fertility, sexual function, and loss of some male traits. Children will not go through puberty.

Not enough growth hormone. Adults with this problem may lose bone and muscle mass. In children it can lead to stunted growth and dwarfism.

Not enough thyroid-stimulating hormone. This often leads to an underactive thyroid. It may cause lack of energy (fatigue), confusion, inability to handle the cold, weight gain, constipation, and dry skin.

Not enough ACTH (adrenocorticotropin hormone). This is rare. It leads to an underactive adrenal gland. You may have low blood pressure, low blood sugar, feel tired, and be easily stressed.

Not enough prolactin. This is rare. Women who lack this hormone may not be able to make breastmilk after childbirth.

Not enough antidiuretic hormone (also called vasopressin). This leads to increased urine output and thirst.

These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is hypopituitarism diagnosed?

Your healthcare provider will ask about your health history. You will also need an exam. Other tests you may need include:

CT scan. This test uses X-rays and computer technology to make detailed images of your body.

MRI. This test uses large magnets, radio waves, and a computer to make images of organs and structures within your body.